WSIS+10 High-Level Event
(an extended version of the WSIS Forum)
10-13 June 2014, (9 June 2014 Pre-event)
ITU Headquarters, Geneva
Open Consultation Process
Official Submission Form #2 on the
Thematic Aspects and Innovations on the Format
Please note that submission should be sent to the wsis-info@itu.int not later than 24 March 2014.
Due to shortage of time it will be difficult to include submissions received after 24 March 2014 in the
Draft Agenda.
A. Your Information
Title:
Choose an item.
First name:
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Organization:
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Organization type:
Last name:
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Choose an item.
Country:
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Email:
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Telephone:
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Address:
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B. Formal Input
All WSIS Stakeholders are invited to submit inputs on the Thematic Aspects and Innovations on the
Format of the Forum track of the WSIS +10 High-Level Event.
Within the mandate of the World Summit on the Information Society, please suggest main topics
and themes that could be discussed and focused on during the Forum track of the WSIS+10 HighLevel Event. Moreover, please submit suggestions and ideas on innovations on its format.
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a) Recommended Speakers
Would you like to recommend any speakers for the Forum track of the WSIS+10 High-level Event?
(Please note that the speakers will be responsible for covering the expenses related to travel and
accommodation)
If so, please specify the following for each speaker:
Name of recommended speaker, Designation, Organization, Address, Email, Telephone Number and
Expertise of the Speaker.
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b) Exhibition Space
Would you like to set up an Exhibition Space at the WSIS+10 High-Level Event?
If so, please specify the theme and the requirements.
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c) Thematic Workshops
Would you like to organize a Thematic Workshop during the Forum track of the WSIS+10 High-Level
Event?
If so please specify the theme.
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d) Knowledge Exchanges / Kick Off Meetings
Would you like to organize a Knowledge Exchange / Kick Off meeting during the Forum track of the
WSIS+10 High-Level Event?
If so, please specify the theme.
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e) Method of Participation
How will you participate in the WSIS+10 High-level Event?
Onsite
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Remotely
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f) Sponsor Participants from Developing Countries
Would you like to support participation (travel and accommodation) of WSIS Stakeholders from
developing countries?
Yes
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No
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g) Sponsor Coffee Break / Reception
Would you like to sponsor a coffee break or reception at the WSIS+10 High-level Event?
Yes
☐
No
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h) Partnership
Would you be interested in partnership offers during the WSIS+10 High-level Event?
Yes
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No
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Please note that submission should be sent to the wsis-info@itu.int not later than 24 March 2014.
Due to shortage of time it will be difficult to include submissions received after 24 March 2014 in the
Draft Agenda.
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